In Traditional Chinese Medicine (TCM), glaucoma is regarded as a systemic manifestation, classified under"Qingfeng Neizhang" (Green Wind Cataract/Glaucoma).
TCM views glaucoma as an internal disharmony where stagnant energy (Qi) and poor blood flow fail to properly nourish the eyes, particularly affecting the Liver meridian.
While Western medicine focuses primarily on lowering intraocular pressure (IOP), TCM serves as an adjunctive, neuroprotective therapy aimed at preserving retinal ganglion cells, improving microcirculation, and controlling oxidative stress.
TCM, as a medical system based on distinctive Chinese cultural theories and practices, has a long history of effective treatments and has been used for more than two thousand years. Glaucoma was first mentioned in the book Shennong Bencao Jing, in which it was described as "green wind glaucoma".
Since the Tang and Song Dynasty, ancient Chinese physicians have put forward unique views on glaucoma treatment. There are two main concepts regarding glaucoma: the green wind glaucoma, also known as “Lvfengneizhang” in ancient medical books, is similar to open-angle glaucoma; while the blue wind glaucoma, known as “Qingfengneizhang” is similar to angle-closure glaucoma. TCM ascribed the pathogenic factors of glaucoma to “excessive heat of liver-gallbladder (Gan Dan Shi Re)”.
Chinese medicine classifies ocular diseases as a hepatic disease, and often treats them with herbs that belong to the liver meridians. TCM generally exerts holistic effects owing to their multi-component and multi-target features, which have a unique advantage for glaucoma treatment.
TREATMENT:
Treatment of glaucoma with TCM is used as an adjunctive, supportive therapy alongside standard Western treatments to help protect the optic nerve and improve ocular blood flow, but it cannot replace conventional treatments for lowering IOP.
Studies, including network pharmacology and clinical reviews, suggest that TCM may target mechanisms of neurodegeneration that conventional pressure-lowering therapies do not fully address.
Neuroprotection: Tonic herbs are studied for protecting Retinal Ganglion Cells (RGCs) from dying due to oxidative stress and excitotoxicity.
Microcirculation: Certain therapies help dilate blood vessels and improve blood flow to the optic nerve and retina.
Integrated Benefits: A meta-analysis published in PubMed indicated that combining standard surgery with TCM significantly improved visual field preservation and vision recovery compared to surgery alone.
HERBS FOR GLAUCOMA:
There are several specific herbs recommended in TCM for glaucoma management:
Ginkgo biloba: Widely recognized for improving ocular blood flow and providing antioxidant-driven neuroprotection.
Lycium barbarum (Goji Berry): Extensively researched for its ability to mitigate oxidative stress and protect RGCs from damage.
Erigeron breviscapus (Dandelion Flower): It supposedly expands the visual field and improves microcirculation in patients with controlled IOP.
Bujing Yishi Tablets: Used in hospital settings in China as a standard preparation to preserve visual function in patients whose IOP is already stable.
ACUPUNCTURE:
If the IOP is controlled within the target range, acupuncture treatment can be performed as an adjunct, especially for patients with obvious visual field damage. Acupuncture treatment contributes to maintain and improve vision as well as expand the field of vision.
Main points: Jingming, Chengqi point, fish waist acupuncture point, Fengchi acupoints; Matching acupoints: Temple, Baihui, Sibai, Hoku;
Main acupoints: Shangjing Ming, Retrobulbar acupoint, Tongzi Liao, Wangu; Matching acupoints: Temple, Waiguan, Ganyu, Shenyu;
Main acupoints: Xiajing Ming, Sibai, Sizhu Kong, Tianzhu; Matching acupoints: Temple, Binao, Zusan Li, Sanyin Jiao.
TCM is an ancient method of treatment and is undergoing modifications based on new knowledge and experience.
REFERENCES:
- Yang Y, Ma QY, Yang Y, He YP, Ma CT, Li Q, Jin M, Chen W. Evidence-based practice guideline of Chinese herbal medicine for primary open-angle glaucoma (qingfeng -neizhang). Medicine (Baltimore). 2018 Mar;97(13):e0126.p doi: 10.1097/MD.0000000000010126. PMID: 29595636; PMCID: PMC5895393.
- Qi SM, Zhang JT, Zhu HY, Wang Z, Li W. Review on potential effects of traditional Chinese medicine on glaucoma. J Ethnopharmacol. 2023 Mar 25;304:116063. doi: 10.1016/j.jep.2022.116063. Epub 2022 Dec 22. PMID: 36567037.
